 |
| Company Name: _____________________________________________________________________________ |
| Representatives Name(s) 1. ______________________________ 2. ____________________________________ |
| Address: _____________________________ City: ______________________ State: _____ Zip: _____________ |
| Phone Number: ____________________ Fax: _______________________ E-mail: ________________________ |
| MENU (booths spaces are 10' x 10', with one 8' table and two chairs) |
| Please indicate number needed. |
| _____ Exhibit space (indoor or outdoor) |
$350.00 |
| _____ Additional Space |
$200.00 |
| _____ Additional Table |
$35.00 |
| _____ Additional Person (two included w/reg.) |
$15.00 |
| Total Fees: _______________ |
|
| EXHIBITION DATES (Please indicated days attending) |
| [ ] Saturday 3/10 |
[ ] Tuesday 3/13 |
| [ ] Sunday 3/11 |
[ ] Wednesday 3/14 |
| [ ] Monday 3/12 |
[ ] Thursday 3/15 | |
| Please remit payment with registration form. |
Send registration to:
AWIMA
1700 Iron Springs Road
Prescott AZ 86305 |
Email Us: info@azwildfireacademy.org
Call Us: (928) 442-3563
FAX Us: (928) 928-771-0407
Visit Us on the Web: azwildfireacademy.org |